Hepatitis E in post-liver transplantation: is it time to routinely consider it?

Area of Science:

• Hepatology
• Virology
• Transplantation Immunology

Background:

• Hepatitis E is underrecognized in Western countries despite its significant impact.
• Liver transplantation outcomes are gravely affected by Hepatitis E virus (HEV) infection.
• Abnormal liver tests warrant consideration of HEV, particularly in transplant settings.

Observation:

• Current detection assays for HEV have notable limitations.
• HEV diagnosis and management require specific pre- and post-liver transplantation considerations.
• Recent data on HEV detection and management are crucial for clinical practice.

Findings:

• The review synthesizes current knowledge on HEV detection and management in liver transplant patients.
• Limitations of existing HEV detection assays are discussed.
• An algorithm for diagnosing and managing pre- and post-transplantation HEV is proposed.

Implications:

• Increased awareness and improved diagnostic strategies for HEV are needed in the West.
• Effective management of HEV can improve outcomes for liver transplant recipients.
• The proposed algorithm can guide clinicians in managing HEV in complex transplant cases.